HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
1< LL LLL
Permit Number:
Building Permit Application
Planning and Development 5ervices
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 4680 Christensen Road
Property Tax ID #: 3403-502-0129-030-6
Site Plan Name:
Project Name: LeBrun
DETAILED DESCRIPTION OF WORK:
ouim croanc
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
Name Samuel LeBrun
Address: 4680 Christensen Road
_ Generator
Sq. Ft. of First Floor:
Residential X
Lot No. 70
Block No.
_ Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
City: Fort Pierce State: _
Zip Code: 34981 Fax:
Phone No. 561-729-6303
E-Mail: samuellebrun300@gmaii.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Erik F. DeLaney
Company: Solar Climatic Corporation
Address: 650 2nd Lane
City: Vero Beach State: FL
Zip Code: 32962 Fax:
Phone No 772-567-3104
E-Mail sales@climaticsolar.com
State or County License CVC56671
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or mare, 2 RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
1Jt31UIVtK/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
ZIP: Phone
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
Address:
City:
ZIP: Phone:
CONTRACTOR AFFIDVIT- e.r.,ii,..i,.., i� i._k..
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
ZIP: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
,_ ._
- - • ----- -- - -•• • - ram•,.,,• ... av .ue: wu, K aria mstauation as indicated.
Certity that noworkor installation has commenced prior to the issuance of a permit.
which is in conflict with anapplicable representation
a that
tAssociatl Association rulewill
s authorize
or andpcovenants that may rthe estrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and poste jkon the jobs* before the first inspection. If you intend obtlin fiUWing, consult
with lender or an attor{iely bi%re,6e16rnenrinw wnr4 nr
Owner
STATE OF FLORIDA
COUNTY OF w—ww,
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or _ Online Notarization
this _day of 2020 by
Edk F. Delaney
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
4odue of NotPaublic- State of Florida ) y.�,,�
Commission No. HH118473 •'s� Short
Notary Public
State of Florida
REVIEWS amFRONT �x i. re
ZONING SU ERVIS
r
COUNTER REVIEW REVIEW
erg—_
STATE OF FLORIDA
COUNTY OF fndinPV r
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or _ Online Notarization
this —day of. J 2020 by
Edk F. DeLaney
Name of person making statement.
Personally Known x
Type of Identification
71
Commission No. HH110e73
PLANS I VEGETATION
REVIEW REVIEW
OR Produced Identification
Hablph Short
Wtary Public
State of Florida
SEA fORTLE
REVIEW I REVIEW